肝脏三维虚拟手术系统的开发建立及其在临床肝切除术中的应用

Development and clinical application of 3D operative planning system of liver in virtual reality environments

目的研发建立三维虚拟现实（VR）肝肿瘤模型，使个体肝脏CT数据可在VR环境中显示、测量和操控。方法利用患者CT二维影像数据建立肝肿瘤三维模型，将其导入虚拟平台——Dextrobeam，在VR环境中对模型进行虚拟肝切除，并评价其临床价值。结果成功建立三维肝脏及其肿瘤模型，并可在VR环境中进行虚拟肝切除；共有38例肝肿瘤患者接受行肝切除术（21例行右半肝切除术、14例行左半肝切除术、3例行扩大右半肝切除术），术中对比显示该系统虚拟性好，术前模拟结果准确。结论三维VR环境中肝肿瘤虚拟手术平台的成功建立对于科学制定手术方案、安全完整的切除肝肿瘤、降低手术风险有重要意义。

Objective To explore and develop three-dimension （3D） virtual reality （VR） liver model and convert computed tomography data into a fully 3D VR environment for display, measure and manipulation. Methods 3D-reconstruction of liver was restored from spiral computed tomography（CT） data by using LiVirtue software. Dextrobeam was used to view the 3D model in the VR environment. The liver and its anatomic structure were reconstructed to illuminate the location of the tumor and its related vessels. Results 3D models of liver,tumor and their relative vessels were reconstructed successfully. These models could be viewed and manipulated in the VR environment on personal computer. 38 patients underwent liver resection, including 21 right hemihepatectomy, 14 left hemihepatectomy and 3 extended right hemihepatectomy. The intraoperative contrast with preoperative simulation confirmed the reliability of our 3D operative planning system. Conclusions The preoperative simulation in 3D VR facilitated liver resection by the ability to view tumor and its relative vessels. This preoperative estimation from 3D model of liver benefits a lot to complicated liver resection.